Provider Demographics
NPI:1639907637
Name:GLASSE, DOROTHY ANN (LCMHC)
Entity type:Individual
Prefix:
First Name:DOROTHY
Middle Name:ANN
Last Name:GLASSE
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6129 REMINGTON LAKE DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-6233
Mailing Address - Country:US
Mailing Address - Phone:919-875-1374
Mailing Address - Fax:
Practice Address - Street 1:6129 REMINGTON LAKE DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27616-6233
Practice Address - Country:US
Practice Address - Phone:919-875-1374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-23
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health